I want to Register my intent to attend now, and handle payment in another way.

None of the above. I am submitting this form to the Committee for other reasons.

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There are two simple pages after this before you can use the Submit button.

Use this form to give the Conference Committee a picture of your attendance for the upcoming conference and to pay for Conference Registration and Banquet Fees.

First Name

Last Name

Email Address

Phone

General Idea of Attendance*

I plan to attend the entire conference

I plan only to attend portions of the conference

I am still planning my attendance

Please let us know

Send me email updates about this conference.

I wish to volunteer to help at the Conference with small tasks.

I wish to volunteer for large tasks at the Conference.

Dietary Restrictions*

No Dietary Restricions

Yes, I have Dietary Restrictions

Dietary Restrictions

Vegetarian

Gluten Free

Other Dietary Restriction

Write Here

I understand that the Conference gives the hotel a general idea about our food preferences and that informing the kitchen as to my Dietary Restrictions is ultimately my responsibility.*

My Dietary Restrictions are my responsibility.

Advertising the Conference

Please tell us of any effective ads that you saw or that helped you find the conference.

Facebook

Youtube

Parabola

Watkins: Mind, Body, Spirit

Flyer

Others

Write here

Thank you for using our form... Please activate the SUBMIT button when you are ready.

To see what the approximate Currency Conversion will be, you can use this calculator: CLICK HERE FOR CURRENCY CALCULATOR. (It opens in a new window/tab, and this form stays in place.)

Donations*

Many people like to donate to the conference to help the scholarship fund, so we provide the opportunity here as well.

Let's consider a donation now.

Skip donations for now...

Donation Slider*

Total

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Payment Method*

Paypal Account

Pay through PayPal

You will be redirected to PayPal checkout page once you submit. After you complete your payment, you will be redirected back to our site with a confirmation.

Package Total

This Form works to send your important information to the Conference Committee even when you select Paypal and then do not complete the paypal process. The Form will still save the information in the right place for the Conference Committee.

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Your form has been submitted

Thank you %NAME% for filling in the AandE Registration Form
We have received your answers. You can view it anytime from this link below:%TRACK_LINK%
We have also attached a copy of your submission.

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